Robotic ultrasonic surgical device with articulating end effector

ABSTRACT

An apparatus for operating on tissue comprises an end effector, a shaft assembly, and an interface assembly. The end effector comprises an ultrasonic blade. The shaft assembly includes an articulation section operable to deflect the end effector away from the longitudinal axis. The interface assembly is operable to drive the end effector. The interface assembly comprises a base and a plurality of drive shafts. The base is configured to couple with a dock of a robotic control system. The drive shafts are oriented perpendicular to the longitudinal axis of the shaft assembly. A first drive shaft may be operable to rotate the shaft assembly relative to the base. A second drive shaft may be operable to drive the articulation section. A third drive shaft may be operable to drive a clamping arm to pivot toward the ultrasonic blade.

BACKGROUND

A variety of surgical instruments include an end effector having a bladeelement that vibrates at ultrasonic frequencies to cut and/or sealtissue (e.g., by denaturing proteins in tissue cells). These instrumentsinclude piezoelectric elements that convert electrical power intoultrasonic vibrations, which are communicated along an acousticwaveguide to the blade element. Examples of such ultrasonic surgicalinstruments include the HARMONIC ACE® Ultrasonic Shears, the HARMONICWAVE® Ultrasonic Shears, the HARMONIC FOCUS® Ultrasonic Shears, and theHARMONIC SYNERGY® Ultrasonic Blades, all by Ethicon Endo-Surgery, Inc.of Cincinnati, Ohio. Further examples of such devices and relatedconcepts are disclosed in U.S. Pat. No. 5,322,055, entitled “ClampCoagulator/Cutting System for Ultrasonic Surgical Instruments,” issuedJun. 21, 1994, the disclosure of which is incorporated by referenceherein; U.S. Pat. No. 5,873,873, entitled “Ultrasonic Clamp CoagulatorApparatus Having Improved Clamp Mechanism,” issued Feb. 23, 1999, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.5,980,510, entitled “Ultrasonic Clamp Coagulator Apparatus HavingImproved Clamp Arm Pivot Mount,” filed Oct. 10, 1997, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 6,325,811,entitled “Blades with Functional Balance Asymmetries for use withUltrasonic Surgical Instruments,” issued Dec. 4, 2001, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 6,783,524,entitled “Robotic Surgical Tool with Ultrasound Cauterizing and CuttingInstrument,” issued Aug. 31, 2004, the disclosure of which isincorporated by reference herein; U.S. Pub. No. 2006/0079874, entitled“Tissue Pad for Use with an Ultrasonic Surgical Instrument,” publishedApr. 13, 2006, the disclosure of which is incorporated by referenceherein; U.S. Pub. No. 2007/0191713, entitled “Ultrasonic Device forCutting and Coagulating,” published Aug. 16, 2007, the disclosure ofwhich is incorporated by reference herein; U.S. Pub. No. 2007/0282333,entitled “Ultrasonic Waveguide and Blade,” published Dec. 6, 2007, thedisclosure of which is incorporated by reference herein; U.S. Pub. No.2008/0200940, entitled “Ultrasonic Device for Cutting and Coagulating,”published Aug. 21, 2008, the disclosure of which is incorporated byreference herein; U.S. Pub. No. 2010/0069940, entitled “UltrasonicDevice for Fingertip Control,” published Mar. 18, 2010, the disclosureof which is incorporated by reference herein; and U.S. Pub. No.2011/0015660, entitled “Rotating Transducer Mount for UltrasonicSurgical Instruments,” published Jan. 20, 2011, the disclosure of whichis incorporated by reference herein, U.S. patent application Ser. No.13/538,588, filed Jun. 29, 2012, entitled “Surgical Instruments withArticulating Shafts,” the disclosure of which is incorporated byreference herein; and U.S. patent application Ser. No. 13/657,553, filedOct. 22, 2012, entitled “Flexible Harmonic Waveguides/Blades forSurgical Instruments,” the disclosure of which is incorporated byreference herein. Additionally, some of the foregoing surgical tools mayinclude a cordless transducer such as that disclosed in and U.S. Pat.App. No. 61/410,603, filed Nov. 5, 2010, entitled “Energy-Based SurgicalInstruments,” the disclosure of which is incorporated by referenceherein.

In addition, a variety of surgical instruments include a shaft having anarticulation section, providing enhanced positioning capabilities for anend effector that is located distal to the articulation section of theshaft. Examples of such devices include various models of the ENDOPATH®endocutters by Ethicon Endo-Surgery, Inc., of Cincinnati, Ohio. Furtherexamples of such devices and related concepts are disclosed in U.S. Pat.No. 7,380,696, entitled “Articulating Surgical Stapling InstrumentIncorporating a Two-Piece E-Beam Firing Mechanism,” issued Jun. 3, 2008,the disclosure of which is incorporated by reference herein; U.S. Pat.No. 7,404,508, entitled “Surgical Stapling and Cutting Device,” issuedJul. 29, 2008, the disclosure of which is incorporated by referenceherein; U.S. Pat. No. 7,455,208, entitled “Surgical Instrument withArticulating Shaft with Rigid Firing Bar Supports,” issued Nov. 25,2008, the disclosure of which is incorporated by reference herein; U.S.Pat. No. 7,506,790, entitled “Surgical Instrument Incorporating anElectrically Actuated Articulation Mechanism,” issued Mar. 24, 2009, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.7,549,564, entitled “Surgical Stapling Instrument with an ArticulatingEnd Effector,” issued Jun. 23, 2009, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 7,559,450, entitled“Surgical Instrument Incorporating a Fluid Transfer ControlledArticulation Mechanism,” issued Jul. 14, 2009, the disclosure of whichis incorporated by reference herein; U.S. Pat. No. 7,654,431, entitled“Surgical Instrument with Guided Laterally Moving Articulation Member,”issued Feb. 2, 2010, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 7,780,054, entitled “Surgical Instrumentwith Laterally Moved Shaft Actuator Coupled to Pivoting ArticulationJoint,” issued Aug. 24, 2010, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 7,784,662, entitled “Surgical Instrumentwith Articulating Shaft with Single Pivot Closure and Double Pivot FrameGround,” issued Aug. 31, 2010, the disclosure of which is incorporatedby reference herein; and U.S. Pat. No. 7,798,386, entitled “SurgicalInstrument Articulation Joint Cover,” issued Sep. 21, 2010, thedisclosure of which is incorporated by reference herein.

Some surgical systems provide robotic control of a surgical instrument.With minimally invasive robotic surgery, surgical operations may beperformed through a small incision in the patient's body. A roboticsurgical system may be used with various types of surgical instruments,including but not limited to surgical staplers, ultrasonic instruments,electrosurgical instruments, and/or various other kinds of instruments,as will be described in greater detail below. An example of a roboticsurgical system is the DAVINCI™ system by Intuitive Surgical, Inc., ofSunnyvale, Calif. By way of further example, one or more aspects ofrobotic surgical systems are disclosed in the following: U.S. Pat. No.5,792,135, entitled “Articulated Surgical Instrument For PerformingMinimally Invasive Surgery With Enhanced Dexterity and Sensitivity,”issued Aug. 11, 1998, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 5,817,084, entitled “Remote CenterPositioning Device with Flexible Drive,” issued Oct. 6, 1998, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.5,878,193, entitled “Automated Endoscope System for OptimalPositioning,” issued Mar. 2, 1999, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 6,231,565, entitled“Robotic Arm DLUS for Performing Surgical Tasks,” issued May 15, 2001,the disclosure of which is incorporated by reference herein; U.S. Pat.No. 6,783,524, entitled “Robotic Surgical Tool with UltrasoundCauterizing and Cutting Instrument,” issued Aug. 31, 2004, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.6,364,888, entitled “Alignment of Master and Slave in a MinimallyInvasive Surgical Apparatus,” issued Apr. 2, 2002, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 7,524,320,entitled “Mechanical Actuator Interface System for Robotic SurgicalTools,” issued Apr. 28, 2009, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 7,691,098, entitled “Platform Link WristMechanism,” issued Apr. 6, 2010, the disclosure of which is incorporatedby reference herein; U.S. Pat. No. 7,806,891, entitled “Repositioningand Reorientation of Master/Slave Relationship in Minimally InvasiveTelesurgery,” issued Oct. 5, 2010, the disclosure of which isincorporated by reference herein; and U.S. Pat. No. 7,824,401, entitled“Surgical Tool With Writed Monopolar Electrosurgical End Effectors,”issued Nov. 2, 2010, the disclosure of which is incorporated byreference herein.

Additional examples of instruments that may be incorporated with arobotic surgical system are described in U.S. Pub. No. 2013/0012957,entitled “Automated End Effector Component Reloading System for Use witha Robotic System, published Jan. 10, 2013, the disclosure of which isincorporated by reference herein; U.S. Pub. No. 2012/0199630, entitled“Robotically-Controlled Surgical Instrument with Force-FeedbackCapabilities,” published Aug. 9, 2012, the disclosure of which isincorporated by reference herein; U.S. Pub. No. 2012/0132450, entitled“Shiftable Drive Interface for Robotically-Controlled Surgical Tool,”published May 31, 2012, the disclosure of which is incorporated byreference herein; U.S. Pub. No. 2012/0199633, entitled “SurgicalStapling Instruments with Cam-Driven Staple Deployment Arrangements,”published Aug. 9, 2012, the disclosure of which is incorporated byreference herein; U.S. Pub. No. 2012/0199631, entitled“Robotically-Controlled Motorized Surgical End Effector System withRotary Actuated Closure Systems Having Variable Actuation Speeds,”published Aug. 9, 2012, the disclosure of which is incorporated byreference herein; U.S. Pub. No. 2012/0199632, entitled“Robotically-Controlled Surgical Instrument with SelectivelyArticulatable End Effector,” published Aug. 9, 2012, the disclosure ofwhich is incorporated by reference herein; U.S. Pub. No. 2012/0203247,entitled “Robotically-Controlled Surgical End Effector System,”published Aug. 9, 2012, the disclosure of which is incorporated byreference herein; U.S. Pub. No. 2012/0211546, entitled “Drive Interfacefor Operably Coupling a Manipulatable Surgical Tool to a Robot,”published Aug. 23, 2012; U.S. Pub. No. 2012/0138660, entitled“Robotically-Controlled Cable-Based Surgical End Effectors,” publishedJun. 7, 2012, the disclosure of which is incorporated by referenceherein; U.S. Pub. No. 2012/0205421, entitled “Robotically-ControlledSurgical End Effector System with Rotary Actuated Closure Systems,”published Aug. 16, 2012, the disclosure of which is incorporated byreference herein; U.S. patent application Ser. No. 13/443,101, entitled“Control Interface for Laparoscopic Suturing Instrument,” filed Apr. 10,2012, the disclosure of which is incorporated by reference herein; andU.S. Provisional Pat. App. No. 61/597,603, entitled “RoboticallyControlled Surgical Instrument,” filed Feb. 10, 2012, the disclosure ofwhich is incorporated by reference herein.

While several surgical instruments and systems have been made and used,it is believed that no one prior to the inventors has made or used theinvention described in the appended claims.

BRIEF DESCRIPTION OF THE DRAWINGS

While the specification concludes with claims which particularly pointout and distinctly claim this technology, it is believed this technologywill be better understood from the following description of certainexamples taken in conjunction with the accompanying drawings, in whichlike reference numerals identify the same elements and in which:

FIG. 1 depicts a block diagram of an exemplary robotic surgical system;

FIG. 2 depicts a perspective view of an exemplary controller of thesystem of FIG. 1;

FIG. 3 depicts a perspective view of an exemplary robotic arm cart ofthe system of FIG. 1;

FIG. 4 depicts a perspective view of an exemplary surgical instrumentsuitable for incorporation with the system of FIG. 1;

FIG. 5 depicts a perspective view of the underside of the base assemblyof the instrument of FIG. 4;

FIG. 6 depicts a perspective view of the end effector and shaft assemblyarticulation section of the instrument of FIG. 4;

FIG. 7 depicts an exploded view of the end effector and articulationsection of FIG. 6;

FIG. 8 depicts a lateral cross-sectional view of the end effector andarticulation section of FIG. 6;

FIG. 9 depicts a perspective view of the end effector and articulationsection of FIG. 6, with an outer sheath omitted and with clamp padfeatures omitted;

FIG. 10 depicts a cross-sectional view of the end effector andarticulation section of FIG. 6, taken along line 10-10 of FIG. 8;

FIG. 11 depicts a cross-sectional view of the end effector andarticulation section of FIG. 6, taken along line 11-11 of FIG. 8;

FIG. 12 depicts a perspective view of the proximal end of the shaftassembly of the instrument of FIG. 4;

FIG. 13 depicts an exploded view of the proximal end of the shaftassembly of the instrument of FIG. 4;

FIG. 14 depicts a perspective view of the proximal end of the instrumentof FIG. 4, with the outer cover omitted;

FIG. 15 depicts a top plan view of the proximal end of the instrument ofFIG. 4, with the outer cover omitted;

FIG. 16 depicts an exploded view of the proximal end of the instrumentof FIG. 4, with the outer cover omitted;

FIG. 17 depicts a lateral cross-sectional view of a proximal portion ofthe proximal end of the instrument of FIG. 4, taken along line 17-17 ofFIG. 15;

FIG. 18 depicts a lateral cross-sectional view of a distal portion ofthe proximal end of the instrument of FIG. 4, taken along line 18-18 ofFIG. 15.

The drawings are not intended to be limiting in any way, and it iscontemplated that various embodiments of the technology may be carriedout in a variety of other ways, including those not necessarily depictedin the drawings. The accompanying drawings incorporated in and forming apart of the specification illustrate several aspects of the presenttechnology, and together with the description serve to explain theprinciples of the technology; it being understood, however, that thistechnology is not limited to the precise arrangements shown.

DETAILED DESCRIPTION

The following description of certain examples of the technology shouldnot be used to limit its scope. Other examples, features, aspects,embodiments, and advantages of the technology will become apparent tothose skilled in the art from the following description, which is by wayof illustration, one of the best modes contemplated for carrying out thetechnology. As will be realized, the technology described herein iscapable of other different and obvious aspects, all without departingfrom the technology. Accordingly, the drawings and descriptions shouldbe regarded as illustrative in nature and not restrictive.

It is further understood that any one or more of the teachings,expressions, embodiments, examples, etc. described herein may becombined with any one or more of the other teachings, expressions,embodiments, examples, etc. that are described herein. Thefollowing-described teachings, expressions, embodiments, examples, etc.should therefore not be viewed in isolation relative to each other.Various suitable ways in which the teachings herein may be combined willbe readily apparent to those of ordinary skill in the art in view of theteachings herein. Such modifications and variations are intended to beincluded within the scope of the claims.

For clarity of disclosure, the terms “proximal” and “distal” are definedherein relative to a robotic surgical driver comprising a proximalhousing having an interface that mechanically and electrically coupleswith a surgical instrument having a distal surgical end effector. Theterm “proximal” refers the position of an element closer to the roboticsurgical driver housing and the term “distal” refers to the position ofan element closer to the surgical end effector of the surgicalinstrument and further away from the housing.

I. Exemplary Robotic Surgical System Overview

FIG. 1 illustrates an exemplary robotic surgical system (10). System(10) comprises at least one controller (14) and at least one arm cart(18). Arm cart (18) is mechanically and/or electrically coupled to oneor more robotic manipulators or arms (20). Each robotic arm (20)comprises one or more surgical instruments (22) for performing varioussurgical tasks on a patient (24). Operation of arm cart (18), includingarms (20) and instruments (22), may be directed by a clinician (12) fromcontroller (14). In some examples, a second controller (14′), operatedby a second clinician (12′), may also direct operation of the arm cart(18) in conjunction with the first clinician (12′). For example, each ofthe clinicians (12, 12′) may control different arms (20) of the cart or,in some cases, complete control of arm cart (18) may be passed betweenthe clinicians (12, 12′). In some examples, additional arm carts (notshown) may be utilized on the patient (24). These additional arm cartsmay be controlled by one or more of the controllers (14, 14′).

Arm cart(s) (18) and controllers (14, 14′) may be in communication withone another via a communications link (16), which may be any suitabletype of wired and/or wireless communications link carrying any suitabletype of signal (e.g., electrical, optical, infrared, etc.) according toany suitable communications protocol. Communications link (16) may be anactual physical link or it may be a logical link that uses one or moreactual physical links. When the link is a logical link the type ofphysical link may be a data link, uplink, downlink, fiber optic link,point-to-point link, for example, as is well known in the computernetworking art to refer to the communications facilities that connectnodes of a network.

FIG. 2 shows an exemplary controller (30) that may serve as a controller(14) of system (10). In this example, controller (30) generally includesuser input assembly (32) having precision user input features (notshown) that are grasped by the surgeon and manipulated in space whilethe surgeon views the surgical procedure via a stereo display (34). Theuser input features of user input assembly (32) may include manual inputdevices that move with multiple degrees of freedom; and that include anactuatable handle for intuitively actuating tools (e.g., for closinggrasping saws, applying an electrical potential to an electrode, etc).Controller (30) of the present example also includes an array offootswitches (38) providing additional control of arms (20) andinstruments (22) to the surgeon. Display (34) may show views from one ormore endoscopes viewing the surgical site within the patient and/or anyother suitable view(s). In addition, a feedback meter (36) may be viewedthrough the display (34) and provide the surgeon with a visualindication of the amount of force being applied to a component ofinstrument (22) (e.g., a cutting member or clamping member, etc.). Othersensor arrangements may be employed to provide controller (30) with anindication as to whether a staple cartridge has been loaded into an endeffector of instrument (22), whether an anvil of instrument (22) hasbeen moved to a closed position prior to firing, and/or some otheroperational condition of instrument (22).

FIG. 3 shows an exemplary robotic arm cart (40) that may serve as of armcart (18) of system (10). In this example, arm cart (40) is operable toactuate a plurality of surgical instruments (50). While threeinstruments (50) are shown in this example, it should be understood thatarm cart (40) may be operable to support and actuate any suitable numberof surgical instruments (50). Surgical instruments (50) are eachsupported by a series of manually articulatable linkages, generallyreferred to as set-up joints (44), and a robotic manipulator (46). Thesestructures are herein illustrated with protective covers extending overmuch of the robotic linkage. These protective covers may be optional,and may be limited in size or entirely eliminated in some versions tominimize the inertia that is encountered by the servo mechanisms used tomanipulate such devices, to limit the volume of moving components so asto avoid collisions, and to limit the overall weight of cart (40).

Each robotic manipulator (46) terminates at an instrument platform (70),which is pivotable, rotatable, and otherwise movable by manipulator(46). Each platform includes an instrument dock (72) that is slidablealong a pair of tracks (74) to further position instrument (50). Suchsliding is motorized in the present example. Each instrument dock (72)includes mechanical and electrical interfaces that couple with aninterface assembly (52) of instrument (50). By way of example only, dock(72) may include four rotary outputs that couple with complementaryrotary inputs of interface assembly (52). Such rotary drive features maydrive various functionalities in instrument (50), such as is describedin various references cited herein and/or as is described in greaterdetail below. Electrical interfaces may establish communication viaphysical contact, inductive coupling, and/or otherwise; and may beoperable to provide electrical power to one or more features ininstrument (50), provide commands and/or data communication toinstrument (50), and/or provide commands and/or data communication frominstrument (50). Various suitable ways in which an instrument dock (72)may mechanically and electrically communicate with an interface assembly(52) of an instrument (50) will be apparent to those of ordinary skillin the art in view of the teachings herein. It should also be understoodthat instrument (50) may include one or more cables that couple with aseparate power source and/or control unit, to provide communication ofpower and/or commands/data to/from instrument (50).

Arm cart (40) of the present example also includes a base (48) that ismovable (e.g., by a single attendant) to selectively position arm cart(40) in relation to a patient. Cart (40) may generally have dimensionssuitable for transporting the cart (40) between operating rooms. Cart(40) may be configured to fit through standard operating room doors andonto standard hospital elevators. In some versions, an automatedinstrument reloading system (not shown) may also be positioned in ornear the work envelope (60) of arm cart (40), to selectively reloadcomponents (e.g., staple cartridges, etc.) of instruments (50).

In addition to the foregoing, it should be understood that one or moreaspects of system (10) may be constructed in accordance with at leastsome of the teachings of U.S. Pat. No. 5,792,135; U.S. Pat. No.5,817,084; U.S. Pat. No. 5,878,193; U.S. Pat. No. 6,231,565; U.S. Pat.No. 6,783,524; U.S. Pat. No. 6,364,888; U.S. Pat. No. 7,524,320; U.S.Pat. No. 7,691,098; U.S. Pat. No. 7,806,891; U.S. Pat. No. 7,824,401;and/or U.S. Pub. No. 2013/0012957. The disclosures of each of theforegoing U.S. patents and U.S. patent Publication are incorporated byreference herein. Still other suitable features and operabilities thatmay be incorporated into system (10) will be apparent to those ofordinary skill in the art in view of the teachings herein.

II. Exemplary Ultrasonic Surgical Instrument with Articulation Feature

FIGS. 4-18 show an exemplary ultrasonic surgical instrument (100) thatmay be used as at least one instrument (50) within system (10). At leastpart of instrument (100) may be constructed and operable in accordancewith at least some of the teachings of U.S. Pat. No. 5,322,055; U.S.Pat. No. 5,873,873; U.S. Pat. No. 5,980,510; U.S. Pat. No. 6,325,811;U.S. Pat. No. 6,783,524; U.S. Pub. No. 2006/0079874; U.S. Pub. No.2007/0191713; U.S. Pub. No. 2007/0282333; U.S. Pub. No. 2008/0200940;U.S. Pub. No. 2010/0069940; U.S. Pub. No. 2011/0015660; U.S. patentapplication Ser. No. 13/538,588; U.S. patent application Ser. No.13/657,553; and/or U.S. Pat. App. No. 61/410,603. The disclosures ofeach of the foregoing patents, publications, and applications areincorporated by reference herein. As described therein and as will bedescribed in greater detail below, instrument (100) is operable to cuttissue and seal or weld tissue (e.g., a blood vessel, etc.)substantially simultaneously. In other words, instrument (100) operatessimilar to an endocutter type of stapler, except that instrument (100)provides tissue welding through application of ultrasonic vibrationalenergy instead of providing lines of staples to join tissue. This sameultrasonic vibrational energy also separates tissue similar to severingof tissue by a translating knife member. It should also be understoodthat instrument (100) may have various structural and functionalsimilarities with the HARMONIC ACE® Ultrasonic Shears, the HARMONICWAVE® Ultrasonic Shears, the HARMONIC FOCUS® Ultrasonic Shears, and/orthe HARMONIC SYNERGY® Ultrasonic Blades. Furthermore, instrument (100)may have various structural and functional similarities with the devicestaught in any of the other references that are cited and incorporated byreference herein.

To the extent that there is some degree of overlap between the teachingsof the references cited herein, the HARMONIC ACE® Ultrasonic Shears, theHARMONIC WAVE® Ultrasonic Shears, the HARMONIC FOCUS® Ultrasonic Shears,and/or the HARMONIC SYNERGY® Ultrasonic Blades, and the followingteachings relating to instrument (100), there is no intent for any ofthe description herein to be presumed as admitted prior art. Severalteachings herein will in fact go beyond the scope of the teachings ofthe references cited herein and the HARMONIC ACE® Ultrasonic Shears, theHARMONIC WAVE® Ultrasonic Shears, the HARMONIC FOCUS® Ultrasonic Shears,and the HARMONIC SYNERGY® Ultrasonic Blades.

Instrument (100) of the present example includes an interface assembly(200), a shaft assembly (110), an articulation section (130), and an endeffector (150). Interface assembly (200) is configured to couple with adock (72) of robotic arm cart (40) and is thereby further operable todrive articulation section (130) and end effector (150) as will bedescribed in greater detail below. As will also be described in greaterdetail below, instrument (100) is operable to articulate end effector(150) to provide a desired positioning relative to tissue (e.g., a largeblood vessel, etc.), then apply ultrasonic vibrational energy to thetissue with end effector (150) to thereby cut and seal the tissue.

As will be described in greater detail below, instrument (100) of thepresent example includes an ultrasonic transducer (120), which isoperable to convert electrical power into ultrasonic vibrations. In someinstances, transducer (120) receives power directly through dock (72).In some other instances, transducer (120) includes a separate cable(302) that directly couples transducer (120) with a generator (300).Such a generator (300) may include a power source and control modulethat is configured to provide a power profile to transducer (120) thatis particularly suited for the generation of ultrasonic vibrationsthrough transducer (120). By way of example only, generator (300) maycomprise a GEN 300 sold by Ethicon Endo-Surgery, Inc. of Cincinnati,Ohio. In addition or in the alternative, generator (300) may beconstructed in accordance with at least some of the teachings of U.S.Pub. No. 2011/0087212, entitled “Surgical Generator for Ultrasonic andElectrosurgical Devices,” published Apr. 14, 2011, the disclosure ofwhich is incorporated by reference herein. Still other suitable formsthat generator (300) may take, as well as various features andoperabilities that generator (300) may provide, will be apparent tothose of ordinary skill in the art in view of the teachings herein. Itshould also be understood that at least part of the functionality ofgenerator (300) may be incorporated directly into interface assembly(200). By way of example only, interface assembly (200) may include anintegral battery or other integral power source, as well as anycircuitry needed to condition power from a battery or other integralpower source to drive ultrasonic transducer (120).

A. Exemplary End Effector and Acoustic Drivetrain

As best seen in FIGS. 6-8, end effector (150) of the present examplecomprises a clamp arm (152) and an ultrasonic blade (160). Clamp arm(152) includes a clamp pad (154) that is secured to the underside ofclamp arm (152), facing blade (160). Clamp arm (152) is pivotallysecured to a distally projecting tongue (133) of a first ribbed bodyportion (132), which forms part of articulation section (130) as will bedescribed in greater detail below. Clamp arm (152) is operable toselectively pivot toward and away from blade (160) to selectively clamptissue between clamp arm (152) and blade (160). A pair of arms (156)extend transversely to clamp arm (152) and are secured to a pin (170)that extends laterally between arms (156). A rod (174) is secured to pin(170). Rod (174) extends distally from a closure tube (176) and isunitarily secured to closure tube (176).

A driving ring (178) is secured to the proximal end of closure tube(176). In particular, and as best seen in FIG. 13, the proximal end ofclosure tube (176) includes a transverse opening (177) that isconfigured to align with a transverse opening (179) of driving ring(178). These openings (177, 179) are configured to receive a set screw(not shown) or other feature that secures driving ring (178) to closuretube (176). Driving ring (178) is slidably and coaxially disposed aboutthe exterior of outer sheath (112); while closure tube (176) is slidablyand coaxially disposed within the interior of outer sheath (112).However, outer sheath (112) includes a longitudinally extending slot(114) that is configured to receive the set screw that secures drivingring (178) to closure tube (176). Thus, slot (114) allows driving ring(178) and closure tube (176) to translate together relative to outersheath (112). The positioning of the set screw in slot (114) alsoprovides rotation of closure tube (176) and driving ring (178) about thelongitudinal axis of outer sheath (112) when outer sheath (112) isrotated about its longitudinal axis as described in greater detailbelow.

As will also be described in greater detail below, interface assembly(200) includes features that are operable to drive driving ring (178),closure tube (176), and rod (174) longitudinally relative to outersheath (112) and relative to articulation section (130). It should beunderstood that this translation of driving ring (178), closure tube(176), and rod (174) will provide pivoting of clamp arm (152) towardblade (160) (when ring (178), tube (176), and rod (174) are translatedproximally); or away from blade (160) (when ring (178), tube (176), androd (174) are translated distally). Rod (174) is sufficiently flexibleto bend with articulation section (130). However, rod (174) hassufficient tensile and compressive strength to drive clamp arm (152)when rod (174) is translated, regardless of whether articulation section(130) is in a straight or bent configuration.

As best seen in FIGS. 7-8 leaf spring (172) is captured between clamparm (152) and clamp pad (172) and abuts the distal face of tongue (133).Leaf spring (172) is resiliently biased to drive clamp arm (152) awayfrom blade (160) to the open position shown in FIGS. 4, 6, and 8. Leafspring (172) thus further biases tube (176) and rod (174) distally. Ofcourse, like other components described herein, leaf spring (172) may beomitted if desired. Furthermore, clamp arm (152) and clamp pad (154) maybe omitted if desired.

Blade (160) of the present example is operable to vibrate at ultrasonicfrequencies in order to effectively cut through and seal tissue,particularly when the tissue is being clamped between clamp pad (154)and blade (160). Blade (160) is positioned at the distal end of anacoustic drivetrain. This acoustic drivetrain includes a transducerassembly (120), a rigid acoustic waveguide (180), and a flexibleacoustic waveguide (166). As best seen in FIGS. 5 and 12-17, transducerassembly (120) includes a set of piezoelectric discs (122) locatedproximal to a horn (182) of rigid acoustic waveguide (180).Piezoelectric discs (122) are coaxially positioned along a proximallyextending bolt (181), which is a unitary feature of acoustic waveguide(180) located proximal to horn (182). An endmass nut (124) is secured tobolt (181), thereby securing piezoelectric discs (122) to rigid acousticwaveguide (180). As noted above, piezoelectric discs (122) are operableto convert electrical power into ultrasonic vibrations, which are thentransmitted along rigid acoustic waveguide (180) to blade (160). Rigidacoustic waveguide (180) is best seen in FIGS. 13 and 17-18. As shown inFIG. 13, rigid acoustic waveguide (180) includes a transverse opening(186) that complements a transverse opening (118) formed in outer sheath(118). A pin (184) is disposed in openings (118, 186) to couple outersheath (112) with rigid acoustic waveguide (180). This coupling providesrotation of acoustic waveguide (180) (and the rest of the acousticdrivetrain) about the longitudinal axis of outer sheath (112) when outersheath (112) is rotated about its longitudinal axis as will be describedin greater detail below. In the present example, opening (186) islocated at a position corresponding to a node associated with resonantultrasonic vibrations communicated through rigid acoustic waveguide(180).

Rigid acoustic waveguide (180) distally terminates in a coupling (188),which can be seen in FIGS. 8-11 and 13. Coupling (188) is secured tocoupling (168) by a double-threaded bolt (169). Coupling (168) islocated at the proximal end of flexible acoustic waveguide (166). Asbest seen in FIGS. 7-11, flexible acoustic waveguide (166) includes adistal flange (136), a proximal flange (138), and a narrowed section(164) located between flanges (138). In the present example, flanges(136, 138) are located at positions corresponding to nodes associatedwith resonant ultrasonic vibrations communicated through flexibleacoustic waveguide (166). Narrowed section (164) is configured to allowflexible acoustic waveguide (166) to flex without significantlyaffecting the ability of flexible acoustic waveguide (166) to transmitultrasonic vibrations. By way of example only, narrowed section (164)may be configured in accordance with one or more teachings of U.S.patent application Ser. No. 13/538,588 and/or U.S. patent applicationSer. No. 13/657,553, the disclosures of which are incorporated byreference herein. It should be understood that either waveguide (166,180) may be configured to amplify mechanical vibrations transmittedthrough waveguide (166, 180). Furthermore, either waveguide (166, 180)may include features operable to control the gain of the longitudinalvibrations along waveguide (166, 180) and/or features to tune waveguide(166, 180) to the resonant frequency of the system.

In the present example, the distal end of blade (160) is located at aposition corresponding to an anti-node associated with resonantultrasonic vibrations communicated through flexible acoustic waveguide(166), in order to tune the acoustic assembly to a preferred resonantfrequency f_(o) when the acoustic assembly is not loaded by tissue. Whentransducer assembly (120) is energized, the distal end of blade (160) isconfigured to move longitudinally in the range of, for example,approximately 10 to 500 microns peak-to-peak, and in some instances inthe range of about 20 to about 200 microns at a predetermined vibratoryfrequency f_(o) of, for example, 55.5 kHz. When transducer assembly(120) of the present example is activated, these mechanical oscillationsare transmitted through waveguides (180, 166) to reach blade (160),thereby providing oscillation of blade (160) at the resonant ultrasonicfrequency. Thus, when tissue is secured between blade (160) and clamppad (154), the ultrasonic oscillation of blade (160) may simultaneouslysever the tissue and denature the proteins in adjacent tissue cells,thereby providing a coagulative effect with relatively little thermalspread. In some versions, an electrical current may also be providedthrough blade (160) and clamp arm (154) to also cauterize the tissue.While some configurations for an acoustic transmission assembly andtransducer assembly (120) have been described, still other suitableconfigurations for an acoustic transmission assembly and transducerassembly (120) will be apparent to one or ordinary skill in the art inview of the teachings herein. Similarly, other suitable configurationsfor end effector (150) will be apparent to those of ordinary skill inthe art in view of the teachings herein.

B. Exemplary Shaft Assembly and Articulation Section

Shaft assembly (110) of the present example extends distally frominterface assembly (200). Articulation section (130) is located at thedistal end of shaft assembly (110), with end effector (150) beinglocated distal to articulation section (130). Shaft assembly (110)includes an outer sheath (112) that encloses drive features and theabove-described acoustic transmission features that couple interfaceassembly (200) with articulation section (130) and end effector (150).Shaft assembly (110) is rotatable about the longitudinal axis defined bysheath (112), relative to interface assembly (200). Such rotation mayprovide rotation of end effector (150), articulation section (130), andshaft assembly (110) unitarily. Of course, rotatable features may simplybe omitted if desired.

Articulation section (130) is operable to selectively position endeffector (150) at various lateral deflection angles relative to thelongitudinal axis defined by sheath (112). Articulation section (130)may take a variety of forms. By way of example only, articulationsection (130) may be configured in accordance with one or more teachingsof U.S. Pub. No. 2012/0078247, the disclosure of which is incorporatedby reference herein. As another merely illustrative example,articulation section (130) may be configured in accordance with one ormore teachings of U.S. patent application Ser. No. 13/538,588 and/orU.S. patent application Ser. No. 13/657,553, the disclosures of whichare incorporated by reference herein. Various other suitable forms thatarticulation section (130) may take will be apparent to those ofordinary skill in the art in view of the teachings herein. It shouldalso be understood that some versions of instrument (10) may simply lackarticulation section (130).

As best seen in FIGS. 6-11 articulation section (130) of the presentexample comprises a first ribbed body portion (132) and a second ribbedbody portion (134), with a pair of articulation bands (140, 142)extending through channels defined at the interfaces between ribbed bodyportions (132, 134). Ribbed body portions (132, 134) are substantiallylongitudinally positioned between flanges (136, 138) of flexibleacoustic waveguide (166). The distal ends of articulation bands (140,142) are unitarily secured to distal flange (136). Articulation bands(140, 142) also pass through proximal flange (138), yet articulationbands (140, 142) are slidable relative to proximal flange (138).

The proximal end of articulation band (140) is secured to a first drivering (250); while the proximal end of articulation band (142) is securedto a second drive ring (251). As best seen in FIGS. 13 and 17, firstdrive ring (250) includes an annular flange (252) and an inwardlyprojecting anchor feature (254); while second drive ring (251) alsoincludes an annular flange (253) and an inwardly projecting anchorfeature (255). The proximal end of articulation band (140) is fixedlysecured within anchor feature (254) while the proximal end ofarticulation band (142) is fixedly secured within anchor feature (255).Drive rings (250, 251) are slidably disposed about the proximal end ofouter sheath (112). Outer sheath (112) includes a pair of longitudinallyextending slots (116, 117) that are configured to respectively receiveanchor features (254, 255). Slots (116, 117) allow drive rings (250,251) to translate relative to outer sheath (112). The positioning ofanchor features (254, 255) in slots (116, 117) also provides rotation ofrings (250, 251) and articulation bands (140, 142) about thelongitudinal axis of outer sheath (112) when outer sheath (112) isrotated about its longitudinal axis as described in greater detailbelow.

As will be described in greater detail below, interface assembly (200)is operable to selectively pull one articulation band (140, 142)proximally by pulling proximally on drive ring (250); whilesimultaneously allowing the other articulation band (140, 142) and drivering (251) to translate distally. It should be understood that, as onearticulation band (140, 142) is pulled proximally, this will causearticulation section (130) to bend, thereby laterally deflecting endeffector (150) away from the longitudinal axis of shaft assembly (110)at an articulation angle. In particular, end effector (150) will bearticulated toward the articulation band (140, 142) that is being pulledproximally. During such articulation, the other articulation band (140,142) will be pulled distally by flange (136). Ribbed body portions (132,134) and narrowed section (164) are all sufficiently flexible toaccommodate the above-described articulation of end effector (150).

C. Exemplary Robotic Arm Interface Assembly

FIGS. 5 and 14-18 show interface assembly (200) of the present examplein greater detail. As shown, interface assembly (200) comprises a base(202) and a housing (204). It should be noted that housing (204) is onlyshown in FIG. 4 and is omitted from FIGS. 5 and 14-18 for the sake ofclarity. Housing (204) comprises a shell that simply encloses drivecomponents. In some versions, housing (204) also includes an electroniccircuit board, chip, and/or other feature that is configured to identifyinstrument (100).

Base (202) is configured to engage dock (72) of robotic arm cart (40).While not shown, it should be understood that base (202) may alsoinclude one or more electrical contacts and/or other features operableto establish electrical communication with a complementary feature ofdock (72). A shaft support structure (206) extends upwardly from base(202) and provides support to shaft assembly (110) (while still allowingshaft assembly (110) to rotate). By way of example only, shaft supportstructure (206) may include a busing, bearings, and/or other featuresthat facilitate rotation of shaft assembly (110) relative to supportstructure (206). As shown in FIG. 5, base (202) further includes threedrive discs (220, 240, 260) that are rotatable relative to base (202).Each disc (220, 240, 260) includes a respective pair of unitary pins(222, 242, 262) that couple with complementary recesses (not shown) indrive elements of dock (72). In some versions, one pin (222, 242, 262)of each pair is closer to the axis of rotation of the corresponding disc(220, 240, 260), to ensure proper angular orientation of disc (220, 240,260) relative to the corresponding drive element of dock (72).

As best seen in FIGS. 14-16, a drive shaft (224, 244, 264) extendsunitarily upwardly from each disc (220, 240, 260). As will be describedin greater detail below, discs (220, 240, 260) are independentlyoperable to provide independent rotation of shaft assembly (110),bending of articulation section (130), and translation of closure tube(176), through independent rotation of drive shafts (224, 244, 264).Base (202) also includes an idle disc (280), which simply does notrotate or drive any components. A pair of fixed pivot pins (282, 284)extend unitarily upwardly from disc (280).

As best seen in FIGS. 14-16, a first helical gear (226) is fixedlysecured to drive shaft (224), such that rotation of the correspondingdisc (220) provides rotation of first helical gear (226). First helicalgear (226) meshes with a second helical gear (230), which is unitarilysecured to a sleeve (232). Sleeve (232) is unitarily secured to outersheath (112). Thus, rotation of first helical gear (226) providesrotation of shaft assembly (110). It should be understood that rotationof first helical gear (226) about a first axis is converted intorotation of second helical gear (230) about a second axis, which isorthogonal to the first axis. A clockwise (CW) rotation of secondhelical gear (230) (viewed from the top down) results in CW rotation ofshaft assembly (110) (viewed from the distal end of shaft assembly (110)toward the proximal end of shaft assembly (110)), depending on thethread orientation of helical gears (226, 230). A counter-clockwise(CCW) rotation of second helical gear (132) (viewed from the top down)results in CCW rotation of shaft assembly (110) (viewed from the distalend of shaft assembly (110) toward the proximal end of shaft assembly(110)), again depending on the thread orientation of helical gears (226,230). It should therefore be understood that shaft assembly (110) may beactuated by rotating drive shaft (224). Other suitable ways in whichshaft assembly (110) may be rotated will be apparent to those ofordinary skill in the art in view of the teachings herein.

As also best seen in FIGS. 14-16, a pair of cylindraceous cams (246,248) are fixedly secured to drive shaft (244), such that rotation of thecorresponding disc (240) provides rotation of cams (246, 248). Cams(246, 248) are both mounted eccentrically to drive shaft (244), suchthat the longitudinal axes of cams (246, 248) are offset from yetparallel to the longitudinal axis of drive shaft (244). In addition,cams (246, 248) are offset in an opposing manner, such that cams (246,248) laterally protrude relative to drive shaft (244) in oppositedirections. Cams (246, 248) are positioned to drive pivot arms (286,288). Pivot arm (286) is pivotally coupled with pivot pin (282); whilepivot arm (288) is pivotally coupled with pivot pin (284). First drivering (250) passes through an opening (287) formed through first drivearm (286); while second drive ring (251) passes through an opening (289)formed through second drive arm (288). Flanges (252, 253) each have anouter diameter that is larger than the inner diameter of thecorresponding opening (287, 289). Flanges (252, 253) thus restrictdistal movement of rings (250, 251) relative to respective drive arms(286, 288).

As drive shaft (244) is rotated, one of cams (246, 248) will pushproximally on the corresponding arm (286, 288), depending on thepositioning of these components and the angular position of cams (246,248) at the time of rotation. In some instances, cam (246) will drivearm (288) proximally, such that arm (288) pivots CCW (viewed from thetop down) about pin (284). Arm (288) will bear against flange (253)during such pivoting, thereby pulling ring (251) and articulation band(142) proximally. This proximal movement of articulation band (142) willcause articulation section (130) to bend, with end effector (150) beingdeflected toward band (142). This bending of articulation section (130)will pull articulation band (140) distally, which will in turn pull ring(250) and its flange (252) distally. The distal motion of flange (252)will drive arm (286) distally, such that arm (286) pivots CW (viewedfrom the top down) about pin (282). Cam (248) will be oriented to permitsuch distal pivoting of arm (286). As drive shaft (244) continues torotate (or if drive shaft (244) is rotated in the opposite direction),the above pushing and pulling will eventually be reversed. In otherwords, cam (248) may drive arm (286) proximally while cam (246) permitsarm (288) to pivot distally during bending of articulation section (130)to provide deflection of end effector (150) toward band (140). It shouldtherefore be understood that articulation section (130) may be actuatedby rotating drive shaft (244). Other suitable ways in which articulationsection (130) may be actuated will be apparent to those of ordinaryskill in the art in view of the teachings herein.

As also best seen in FIGS. 14-16, a cylindraceous cam (266) is fixedlysecured to drive shaft (264), such that rotation of the correspondingdisc (260) provides rotation of cam (266). Cam (266) is mountedeccentrically to drive shaft (264), such that the longitudinal axis ofcam (266) is offset from yet parallel to the longitudinal axis of driveshaft (264). Cam (266) is disposed in an oblong opening (272) formedthrough a rack (270), which is translatable relative to base (202). Rack(270) includes a laterally extending fork (274). Fork (274) is disposedin an annular recess (278) of driving ring (178), which is secured toclosure tube (176) as noted above. The configuration of cam (266) andthe configuration of recess (272) provide a relationship whereby rack(270) translates longitudinally in response to rotation of drive shaft(264) and cam (266). This translation of rack (270) provides translationof closure tube (176) due to the engagement between fork (274) anddriving ring (178); and the engagement between driving ring (178) andclosure tube (176). It should therefore be understood that clamp arm(152) may be selectively driven away from or toward blade (160) byrotating drive shaft (264). Other suitable ways in which clamp arm (152)may be actuated will be apparent to those of ordinary skill in the artin view of the teachings herein.

D. Exemplary Operation

In an exemplary use, arm cart (40) is used to insert end effector (150)into a patient via a trocar. Articulation section (130) is substantiallystraight, and clamp arm (152) is pivoted toward blade (160), when endeffector (150) and part of shaft assembly (110) are inserted through thetrocar. Drive shaft (224) may be rotated through drive features in dock(72) that are coupled with the corresponding disc (220), to position endeffector (150) at a desired angular orientation relative to the tissue.Drive shaft (244) may then be rotated through drive features in dock(72) that are coupled with the corresponding disc (240), to pivot orflex articulation section (130) of shaft assembly (110) in order toposition end effector (150) at a desired position and orientationrelative to an anatomical structure within the patient. Drive shaft(264) may then be rotated through drive features in dock (72) that arecoupled with the corresponding disc (260), to pivot clamp arm (152) awayfrom blade (160), thereby effectively opening end effector (150).

Tissue of the anatomical structure is then captured between clamp pad(154) and blade (160) by rotating drive shaft (264) to advance closuretube (176) distally, by actuating drive features in dock (72) that arecoupled with the corresponding disc (260). In some instances, thisinvolves clamping two layers of tissue forming part of a natural lumendefining anatomical structure (e.g., blood vessel, portion ofgastrointestinal tract, portion of reproductive system, etc.) in apatient; though it should be understood that instrument (100) may beused on various kinds of tissues and anatomical locations. With tissuecaptured between clamp pad (154) and blade (160), transducer (120) isactivated to provide ultrasonic vibrations at blade (160). Thissimultaneously severs the tissue and denatures proteins in adjacenttissue cells, thereby providing a coagulative effect with relativelylittle thermal spread.

The above operation of shaft assembly (110), articulation section (130),and end effector (150) may be repeated as many times as desired invarious locations within the patient. When the operator wishes towithdraw end effector (150) from the patient, drive shaft (244) may berotated through drive features in dock (72) that are coupled with thecorresponding disc (240), to straighten articulation section (130).Drive shaft (264) may be rotated through drive features in dock (72)that are coupled with the corresponding disc (260), to pivot clamp arm(152) toward blade (160), thereby effectively closing end effector(150). Arm cart (40) is then used to withdraw end effector (150) fromthe patient and trocar. Other suitable ways in which instrument (100)may be operable and operated will be apparent to those of ordinary skillin the art in view of the teachings herein.

III. Miscellaneous

It should be understood that any of the versions of instrumentsdescribed herein may include various other features in addition to or inlieu of those described above. By way of example only, any of theinstruments described herein may also include one or more of the variousfeatures disclosed in any of the various references that areincorporated by reference herein.

While the examples herein are described mainly in the context ofelectrosurgical instruments, it should be understood that variousteachings herein may be readily applied to a variety of other types ofdevices. By way of example only, the various teachings herein may bereadily applied to other types of electrosurgical instruments, tissuegraspers, tissue retrieval pouch deploying instruments, surgicalstaplers, surgical clip appliers, ultrasonic surgical instruments, etc.

In versions where the teachings herein are applied to an electrosurgicalinstrument, it should be understood that the teachings herein may bereadily applied to an ENSEAL® Tissue Sealing Device by EthiconEndo-Surgery, Inc., of Cincinnati, Ohio. In addition or in thealternative, it should be understood that the teachings herein may bereadily combined with the teachings of one or more of the following:U.S. Pat. No. 6,500,176 entitled “Electrosurgical Systems and Techniquesfor Sealing Tissue,” issued Dec. 31, 2002, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 7,112,201 entitled“Electrosurgical Instrument and Method of Use,” issued Sep. 26, 2006,the disclosure of which is incorporated by reference herein; U.S. Pat.No. 7,125,409, entitled “Electrosurgical Working End for ControlledEnergy Delivery,” issued Oct. 24, 2006, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 7,169,146 entitled“Electrosurgical Probe and Method of Use,” issued Jan. 30, 2007, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.7,186,253, entitled “Electrosurgical Jaw Structure for Controlled EnergyDelivery,” issued Mar. 6, 2007, the disclosure of which is incorporatedby reference herein; U.S. Pat. No. 7,189,233, entitled “ElectrosurgicalInstrument,” issued Mar. 13, 2007, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 7,220,951, entitled“Surgical Sealing Surfaces and Methods of Use,” issued May 22, 2007, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.7,309,849, entitled “Polymer Compositions Exhibiting a PTC Property andMethods of Fabrication,” issued Dec. 18, 2007, the disclosure of whichis incorporated by reference herein; U.S. Pat. No. 7,311,709, entitled“Electrosurgical Instrument and Method of Use,” issued Dec. 25, 2007,the disclosure of which is incorporated by reference herein; U.S. Pat.No. 7,354,440, entitled “Electrosurgical Instrument and Method of Use,”issued Apr. 8, 2008, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 7,381,209, entitled “ElectrosurgicalInstrument,” issued Jun. 3, 2008, the disclosure of which isincorporated by reference herein; U.S. Pub. No. 2011/0087218, entitled“Surgical Instrument Comprising First and Second Drive SystemsActuatable by a Common Trigger Mechanism,” published Apr. 14, 2011, thedisclosure of which is incorporated by reference herein; U.S. Pub. No.2012/0116379, entitled “Motor Driven Electrosurgical Device withMechanical and Electrical Feedback,” published May 10, 2012, thedisclosure of which is incorporated by reference herein; U.S. Pub. No.2012/0078243, entitled “Control Features for Articulating SurgicalDevice,” published Mar. 29, 2012, the disclosure of which isincorporated by reference herein; U.S. Pub. No. 2012/0078247, entitled“Articulation Joint Features for Articulating Surgical Device,”published Mar. 29, 2012, the disclosure of which is incorporated byreference herein; U.S. Pub. No. 2013/0030428, entitled “SurgicalInstrument with Multi-Phase Trigger Bias,” published Jan. 31, 2013, thedisclosure of which is incorporated by reference herein; and/or U.S.Pub. No. 2013/0023868, entitled “Surgical Instrument with Contained DualHelix Actuator Assembly,” published Jan. 31, 2013, the disclosure ofwhich is incorporated by reference herein. Other suitable ways in whichthe teachings herein may be applied to an electrosurgical instrumentwill be apparent to those of ordinary skill in the art in view of theteachings herein.

In versions where the teachings herein are applied to a surgicalstapling instrument, it should be understood that the teachings hereinmay be combined with the teachings of one or more of the following, thedisclosures of all of which are incorporated by reference herein: U.S.Pat. No. 7,380,696; U.S. Pat. No. 7,404,508; U.S. Pat. No. 7,455,208;U.S. Pat. No. 7,506,790; U.S. Pat. No. 7,549,564; U.S. Pat. No.7,559,450; U.S. Pat. No. 7,654,431; U.S. Pat. No. 7,780,054; U.S. Pat.No. 7,784,662; and/or U.S. Pat. No. 7,798,386. Other suitable ways inwhich the teachings herein may be applied to a surgical staplinginstrument will be apparent to those of ordinary skill in the art inview of the teachings herein.

It should also be understood that the teachings herein may be readilyapplied to any of the instruments described in any of the otherreferences cited herein, such that the teachings herein may be readilycombined with the teachings of any of the references cited herein innumerous ways. Other types of instruments into which the teachingsherein may be incorporated will be apparent to those of ordinary skillin the art.

It should be appreciated that any patent, publication, or otherdisclosure material, in whole or in part, that is said to beincorporated by reference herein is incorporated herein only to theextent that the incorporated material does not conflict with existingdefinitions, statements, or other disclosure material set forth in thisdisclosure. As such, and to the extent necessary, the disclosure asexplicitly set forth herein supersedes any conflicting materialincorporated herein by reference. Any material, or portion thereof, thatis said to be incorporated by reference herein, but which conflicts withexisting definitions, statements, or other disclosure material set forthherein will only be incorporated to the extent that no conflict arisesbetween that incorporated material and the existing disclosure material.

Versions described above may be designed to be disposed of after asingle use, or they can be designed to be used multiple times. Versionsmay, in either or both cases, be reconditioned for reuse after at leastone use. Reconditioning may include any combination of the steps ofdisassembly of the device, followed by cleaning or replacement ofparticular pieces, and subsequent reassembly. In particular, someversions of the device may be disassembled, and any number of theparticular pieces or parts of the device may be selectively replaced orremoved in any combination. Upon cleaning and/or replacement ofparticular parts, some versions of the device may be reassembled forsubsequent use either at a reconditioning facility, or by a userimmediately prior to a procedure. Those skilled in the art willappreciate that reconditioning of a device may utilize a variety oftechniques for disassembly, cleaning/replacement, and reassembly. Use ofsuch techniques, and the resulting reconditioned device, are all withinthe scope of the present application.

By way of example only, versions described herein may be sterilizedbefore and/or after a procedure. In one sterilization technique, thedevice is placed in a closed and sealed container, such as a plastic orTYVEK bag. The container and device may then be placed in a field ofradiation that can penetrate the container, such as gamma radiation,x-rays, or high-energy electrons. The radiation may kill bacteria on thedevice and in the container. The sterilized device may then be stored inthe sterile container for later use. A device may also be sterilizedusing any other technique known in the art, including but not limited tobeta or gamma radiation, ethylene oxide, or steam.

Having shown and described various embodiments of the present invention,further adaptations of the methods and systems described herein may beaccomplished by appropriate modifications by one of ordinary skill inthe art without departing from the scope of the present invention.Several of such potential modifications have been mentioned, and otherswill be apparent to those skilled in the art. For instance, theexamples, embodiments, geometric s, materials, dimensions, ratios,steps, and the like discussed above are illustrative and are notrequired. Accordingly, the scope of the present invention should beconsidered in terms of the following claims and is understood not to belimited to the details of structure and operation shown and described inthe specification and drawings.

I/we claim:
 1. An apparatus for operating on tissue, the apparatus comprising: (a) an end effector, wherein the end effector comprises an ultrasonic blade; (b) a shaft assembly, wherein the end effector is disposed at a distal end of the shaft assembly, wherein the shaft assembly defines a longitudinal axis, wherein the shaft assembly includes an articulation section operable to deflect the end effector away from the longitudinal axis; and (c) an interface assembly, wherein the interface assembly is configured to drive the end effector, wherein the interface assembly comprises: (i) a base, wherein the base is configured to couple with a dock of a robotic control system, and (ii) a plurality of drive shafts oriented perpendicular to the longitudinal axis.
 2. The apparatus of claim 1, wherein the shaft assembly is rotatable relative to the interface assembly.
 3. The apparatus of claim 2, wherein a first drive shaft of the plurality of drive shafts is rotatable to rotate the shaft assembly relative to the interface assembly.
 4. The apparatus of claim 3, wherein the shaft assembly and the first drive shaft include meshing helical gears.
 5. The apparatus of claim 1, wherein the end effector further comprises a clamp arm, wherein the clamp arm is operable to pivot relative to the ultrasonic blade.
 6. The apparatus of claim 5, wherein a first drive shaft of the plurality of drive shafts is rotatable to pivot the clamp arm toward the ultrasonic blade.
 7. The apparatus of claim 6, wherein the shaft assembly comprises a translating member coupled between the first drive shaft and the clamp arm.
 8. The apparatus of claim 7, wherein the interface assembly further comprises: (i) an eccentric cam secured to the first drive shaft, and (ii) a rack coupled with the translating member, wherein the eccentric cam is operable to drive the rack proximally in response to rotation of the first drive shaft, to thereby pivot the clamp arm toward the ultrasonic blade.
 9. The apparatus of claim 1, wherein the articulation section comprises a first articulation band, wherein the first articulation band is translatable relative to the shaft assembly to deflect the end effector away from the longitudinal axis.
 10. The apparatus of claim 9, wherein the articulation section further comprises a second articulation band, wherein the first articulation band is translatable relative to the shaft assembly to deflect the end effector away from the longitudinal axis in a first direction, wherein the second articulation band is translatable relative to the shaft assembly to deflect the end effector away from the longitudinal axis in a second direction.
 11. The apparatus of claim 9, wherein a first drive shaft of the plurality of drive shafts is rotatable to translate the first articulation band.
 12. The apparatus of claim 11, wherein the interface assembly further comprises: (i) an eccentric cam secured to the first drive shaft, and (ii) a pivoting arm coupled with the first articulation band, wherein the eccentric cam is operable to drive the pivoting arm proximally in response to rotation of the first drive shaft, to thereby deflect the end effector away from the longitudinal axis.
 13. The apparatus of claim 9, wherein the articulation section comprises a pair of ribbed bodies, wherein the first articulation band is apposed between the pair of ribbed bodies.
 14. The apparatus of claim 1, wherein the shaft assembly comprises: (i) a rigid acoustic waveguide, and (ii) a flexible acoustic waveguide, wherein the flexible acoustic waveguide extends through the articulation section, wherein the rigid acoustic waveguide and the flexible acoustic waveguide are coupled together, wherein the rigid acoustic waveguide and the flexible acoustic waveguide are operable to transmit ultrasonic vibrations to the ultrasonic blade.
 15. The apparatus of claim 14, wherein the flexible acoustic waveguide includes a narrowed section configured to provide flexing of the flexible acoustic waveguide.
 16. The apparatus of claim 15, wherein the flexible acoustic waveguide further comprises a distal flange and a proximal flange, wherein the narrowed section is longitudinally positioned between the distal flange and the proximal flange.
 17. The apparatus of claim 1, wherein the base comprises a plurality of drive discs, wherein the drive discs are operable to rotate the drive shafts.
 18. The apparatus of claim 17, wherein the drive discs each comprise a respective pair of pins, wherein the pins are configured to couple with complementary drive features of a robotic control system.
 19. An apparatus for operating on tissue, the apparatus comprising: (a) an end effector, wherein the end effector comprises an ultrasonic blade; (b) a shaft assembly, wherein the end effector is disposed at a distal end of the shaft assembly, wherein the shaft assembly defines a longitudinal axis, wherein the shaft assembly includes an articulation section operable to deflect the end effector away from the longitudinal axis; and (c) an interface assembly, wherein the interface assembly is configured to drive the end effector, wherein the interface assembly comprises: (i) a base, wherein the base is configured to couple with a dock of a robotic control system, (ii) a plurality of drive shafts, wherein at least one of the drive shafts is operable to drive the articulation section, and (iii) a plurality of drive discs associated with the plurality of drive shafts, wherein the drive discs each comprise a respective pair of pins, wherein the pins are configured to couple with complementary drive features of a robotic control system.
 20. An apparatus for operating on tissue, the apparatus comprising: (a) an end effector, wherein the end effector comprises an ultrasonic blade; (b) a shaft assembly, wherein the end effector is disposed at a distal end of the shaft assembly, wherein the shaft assembly defines a longitudinal axis, wherein the shaft assembly includes an articulation section operable to deflect the end effector away from the longitudinal axis; (c) an interface assembly, wherein the interface assembly is configured to drive the end effector, wherein the interface assembly comprises: (i) a base, and (ii) a plurality of drive shafts, wherein the drive shafts are rotatable relative to the base; and (d) a robotic control system, wherein the robotic control system comprises: (i) a robotic arm including a dock, wherein the base is configured to couple with the dock, wherein the dock includes drive features operable to couple with the drive shafts, and (ii) a user interface assembly, wherein the user interface assembly is operable to remotely control the drive features. 